Thyroid UK
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Depressed

I really am depressed. 7 years of feeling ill , not feeling any better. Time for anti depressants? Taking 175mcg levo.

Dec 2017

TSH 4.55 (0.2 - 4.2)

FT4 13.8 (12 - 22)

FT3 3.4 (3.1 - 6.8)

Ferritin 18 (15 - 150)

Folate 2.2 (2.5 - 19.5)

Vitamin B12 241 (190 - 900)

Vitamin D 38.8 (25 - 50)

Calcium 2.25 (2.20 - 2.60)

Calcium adjusted 2.23 (2.20 - 2.60)

Taking the following supplements

B12 injections every 3 months

5mg folic acid

Thanks

35 Replies
oldestnewest

I wouldn't take antidepressants.

These blood tests results need urgent attention, how old are they?

Your TSH is too high. FT3 & FT4 are too low - didn't your doctor tell you to up your dose to 200mcg?

How are your levels of :

Vitamin D, Calcium;

B12, Folate

and Ferritin?

If you haven't had these tested then ask GP to do blood tests asap. If you've had them done then please add results in here for comment.

Are you taking any supplements?

On any other medication?

Have any other conditions?

Once you are on stable on correct dose, and have any nutrients deficiencies treated, you should start to feel better.

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They are 1 month old. GP says on enough Levo. I don't feel I'm on enough. I supplement vit D, ferritin, folate and B12. I also have brittle bone in my leg and eczema. No medication

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No you are not getting enough thyroxine . .ideal reading should be around 1. Your doctor needs educating. If you have a good chemist they may confirm if you show them results? Is the brittle bone a pre-existing condition? Afraid I know nothing about this but may why doc not prescribing more due to connection betwen thyroid disease and osteoporosis. You need to talk this through.

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Brittle bones not pre existing, I have a bone fracture caused by an injury

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Okay phew I was worried it was Brittle bone disease which is very different. Yep you need to get those readings down by upping your meds.

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Did you have a DXA scan? Do you have clinical findings/ diagnosis of Osteopenia or Osteoporosis? Is the 'brittle bone' in your leg due to an old injury or have you been told that you have Brittle Bone disease?

What date were the nutrients results and have you any previous nutrients tests results? Were you on supplements when these tests were taken and if so for how long?

If you had been on 800 IU Vitamin D for a long time before these results perhaps you should ask your GP for a higher daily maintenance dose than the minimm? Such as, 1000 or 2000 IU ?

When is your next B12 injection due?

What are you taking for low Ferritin? Did you have an iron infusion? Are you able to eat liver once a week and spinach & leafy greens?

Do you eat a full balanced diet usually?

If GP won't increase Levothyroxine, see a different GP and/or ask for an urgent referal to an Endocrinologist.

Is there anyone you can take with you to GP?

When do you take your Levothyroxine tablets and when do you take your supplements?

Did you have any tests to check your Adrenals?

The correct response to these Thyroid Function blood tests results one month ago should have been an increase to 200mcg Levothyroxine and another test in the next couple of weeks.

Make sure you are retested 6 weeks after starting 200mg.

You need TSH much lower.

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The brittle bone is a leg injury, would that be from osteoporosis? DEXA scan never been done. Nutrient levels taken December 2017. Have been on folic acid for a year, Vit D for 6 years, B12 for 3 months. I take Levothyroxine in the morning and supplements 8 hours apart. No test for adrenals thanks

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Firstly , why are you waiting 8 hours before taking supplements? As far as I am aware, it's best to take supplements as early as possible in the day and with or after food - to get the most beneit from them.

You can't take them first thing because of Levothyroxine so why not take them with lunch or a mid-morning snack?

Osteoporosis?

No one on here can diagnose. Why do you think you have this? Were you ever told you had Rickets? Did a doctor tell you that your leg injury is because of brittle bone? ? You need to ask about this and ask for tests if concerned. Could you be confusing and old fracture with a disease you don't have?

Enquire about your Vitamin D and Calcium results. When is next test.

I made a mistake on my last reply :

that's . . . 200mcg and NOT 200mg, Sorry !

🐥

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ps

Ask your GP to test for Pernicious Anemia or refer you to a Specialist.

If you've taken Folic Acid 5mg for a year and Folate result is still under range - this doesn't seem right to me.

You could also put these results (B12 and Folate ) on Pernicious Anemia forum with symptoms and mention you've been taking Folic Acid 5mg for a year before these tests. See what they advise.

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I wait 8 hours before taking supplements so I don't affect levo absorption. I have a brittle bone in my leg, GP wants to investigate why it is not healing.

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I'm not sure but don't think it's helpful to take supplements at night.

There's no need to wait more than 2 hours after Levo for some and 4 hours for other supplements. Supplements are needed in the day. At night we fast.

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Your tests suggest you're still hypo, which of course would explain your depression. Try to avoid antidepressants, if for no other reason than the hell in store for weaning yourself off them again. I've been much helped in my depression by probiotics. Google about it and judge for yourself but they've been as good as Citalopram for me, with none of the ghastly side effects.

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I agree with other comments. No point in trying antidepressants when your thyroid levels not right. I also had gps trying to give me antidepressants when my thyroid was messed up . But that is such bad advice!! Maybe also try a diet related approach in parallel? And get some good quality supplements ...Good luck

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Your tests suggests both not sufficient levels of vitamins and minerals involved into T4/T3 conversion and insufficient hormonal levels.

I was faced with the same dilemma some time ago but I have really felt that depression was not "my own" and chosen not to swallow happy pills but approach the HRT treatment. Though I was a bit off (part of depression was there for a reason) the treatment changes made the difference and slowly allowed me to get better.

What I want to say it's that it is possible to get better. For me key it was addressing both treatment scheme and psychological factors, including lifestyle.

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Oh yes, you make a good point, Caesard, in reminding Lynette that there is a way forward and she doesn't have to remain depressed if she can get her hypothyroidism and B12 up to healthy levels.

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As others have said you are under medicated. Your GP clearly is prescribing by the TSH and saying if that is in range you are fine. This is incorrect. Prescribing by the TSH always leads to under medication. Your GP should be looking at your thyroid hormone levels. These need to be in the top third or even near the top of the range. Your feelings of depression are a result of being under medicated. Your need an increase in medication ,probably more than one. So it should have been increased to 200mcg and reviewed after 6-8weeks and increased again until yiur TSH is under 1 and most importsmtly your thyroid hormones have improved as described above until your symptoms have abated.

In your shoes I would try a different GP in the practise. Read up on hypothyroidism as many GPs am afraid are quite ill informed. Look on thyroid Uks website there is useful info on there and also a book list of good books to read. A good one is Living with your Thyroid by Barry Pearfield.

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TSH above range, it is 4.55 and cut off is 4.2. thanks

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Exactly!!! Your TSH is tooo high! It needs to be under 1. The TSH otherwise called Thyroid Stimulating Hormone is released by the pitutory when you dont have enough thyroid hormones. It is telling your thyroid to produce more. Your thyroid cant as its not functioning properly which is why you are on levothyroxine. If your GP raised your levothyroxine dose your TSH should reuce & your thyroid hormones would start to go up in their ranges as they need too.

In other words you need your TSH to be very low and your thyroid hormones to be higher but in the top third of their ranges.

I hope this makes sense!

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My TSH is close to zero, but my T3 is often quite low and I'm not okay. The TSH doesn't change much when my T3 improves, but I feel much better. I have never had TSH as high as 4.2. I felt bad enough when it was 2 point something. The ranges your GP is working off should be scrapped. You will find that many people on this forum who have got some control over their thyroid health will agree with me on this. It is difficult if you have not previously engaged in such forums, because we all come from a norm that says our GPs must be right, so we must be wrong... but it ain't so in this case.

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You are very under medicated. Dose should be increased by 25mcgs steps, retesting 6-8 weeks after each dose increase, until TSH is around one and FT4 towards top of range and FT3 at least half way in range

Dr Toft, past president of the British Thyroid Association and leading endocrinologist, states in Pulse Magazine,

"The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l.

In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l.

Most patients will feel well in that circumstance. But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l.

This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l)."

You can obtain a copy of the articles from Thyroid UK email print it and highlight question 6 to show your doctor

please email Dionne:
tukadmin@thyroiduk.org

Do you have Hashimoto's also called autoimmune thyroid disease diagnosed by high thyroid antibodies?

Your vitamin D is far too low, 800iu is rarely enough with thyroid problems, especially Hashimoto's. Needs increasing until level is around 100nmol

Better You" vitamin D mouth spray is good as avoids poor gut function caused by being hypo

Try 3000iu spray once a day. Retesting 2-3 months time via

vitamindtest.org.uk

Likely to need at least 2000iu just as maintenance dose. Test twice yearly.

B12 is too low, so can you push for more frequent injections, or many of us supplement with B12 sublingual lozenges daily

Folic acid is too low, are you taking daily? If not increase to daily

Also many of us find a good vitamin B complex with folate in helps keep all the B vitamins up

If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 3-5 days before any blood tests, as biotin can falsely affect test results

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

Your ferritin is terrible. Ask GP for full iron panel. You should be prescribed ferrous fumerate 2-3 daily.

All these are low because you are under medicated

Detailed supplements advice from SeasideSusie on Low vitamins due to under medication

healthunlocked.com/thyroidu...

Prof Toft - article just published now saying T3 is likely essential for many or we have to have high dose Levo and suppressed TSH

rcpe.ac.uk/sites/default/fi...

Taking vitamin C alongside Levo may help improve uptake

watermark.silverchair.com/j...

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TPO antibodies 674 (<34)

TG antibodies 1200 (<115)

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Very high antibodies. You have Hashimoto's

TPO above 34

TG above 115

Ask GP for coeliac blood test before changing to strictly gluten free diet. Try it for at least 6 months. Majority find it helps

Read as much as possible about Hashimoto's

The Thyroid Secret video series on YouTube is good

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TIme for your thyroid hormone replacement therapy to be optimised - you are undermedicated! I agree with the comments above, demand something is done about it and refuse to be fobbed off with antidepressants which are totally inappropriate in your case.

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Anti-depressants? Probably not. New doctor? Probably yes.

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Ask your Dr. to start you on T3. I was depressed for almost 10 years. Dr. added Liothyronine 2 months ago and I feel so much better. Not perfect but heading in the right direction. Please don't go to antidepressants. Dr said that I could take all of the levo I wanted but my body couldn't convert it to T3. So, maybe you can just give it a try, hopefully it will help you too.

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If your gut health is compromised by all those medications/your health condition, then you need to fix your gut, because our gut is our second brain and if it has an in-balance of bad bacteria/not enough good, then you will get depressed and many other health problems too. I suggest some fermented foods/broad sprectrum probiotics and then your mood should change for the better!

universityhealthnews.com/da...

organixx.com/effect-gut-bac...

Also, if you are taking supplements of Calcium and Vitamin D, then you MUST also supplement with K2 and Magnesium, otherwise you will risk calcifying your arteries and soft tissues and Vitamin D cannot work without adequate Magnesium!!!

easy-immune-health.com/magn...

ncbi.nlm.nih.gov/pubmed/284...

articles.mercola.com/sites/...

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No vit D or calcium

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If you have been supplementing for a year, then these results indicate an absorption problem. Someone suggested to check coeliac. Definitely.

I know someone like you. She was also on 175 mcg T4 but her blood test levels were low. The endocrinologist did a coeliac screen and then the gastroenterologist did a biopsy. She was positive for coeliac. She has been gluten free for 3 years now and feels a lot better.

However, she broke a bone last year and this was because the protein component of her bones was poor due to the years of poor nutrient absorption due to coeliac. She's now taking some supplements to help get her bones healthier. Not sure what she's taking.

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You are hypothyroid and your B12 is very low. That will cause depression because you will no be able to function until both are brought up to a good level.

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Hi are you seing a pscychologist and pschytrist.Talking really helps talking to a stranger.Many a Times depression is from psychosocial circumstances.Try and treat the cause .no it is difficult but source help

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With a TSH over range and deficient minerals and vitamins? Really?

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zeeZee

Correct levels of medication and correct treatment for B12, Folate etc is what is required.

The poster has been left in a Hypothyroid state - physical cause of symptoms. Medical neglect.

This is what needs sorting.

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Thank you

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Hi again zeeZee. I do agree with you that talking to a stranger helps.

x 🐥

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Try instead of drinking the vitamen tablets but rather the actual source e.g. carrots .green vegetables .fish .etc .also your 2 litre water.And some exercise. If you not an exicise person focus on a hobby you enjoy to keep mind busy.It most definitely is extremely difficult. Talking is easier as I truly relate. BUT WITH EATING HEALTHY AND BUSY YOU KILLING 2 BIRDS WITH 1 STONE HEALTH AND CONTENTMENT.OF COURSE ONLY IF THIS IS NOT A MEDICAL PROBLEM

AND OF COURSE SURROUNDING ISSUES

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